🎙️ MSRA Podcast – Acute Bacterial Sinusitis (ABS)
A high-yield, focused breakdown of a deceptively common ENT condition that frequently comes up in the MSRA. Understand the key features, timing-based diagnosis, and when antibiotics are actually needed.

🧠 Key Learning Points

📌 Definition
• Infection of the paranasal sinuses (frontal, maxillary, ethmoid, sphenoid)
• Usually follows a viral upper respiratory infection
• Often referred to as "rhinosinusitis"

📌 Classification by Duration
• Acute: 7–30 days
• Subacute: 4–12 weeks
• Chronic: >12 weeks
• Recurrent: ≥3 episodes/year (≥10 days each)

📌 Key Diagnostic Clue
🕒 Symptoms lasting >10 days OR worsening after initial improvement → suggests bacterial cause
🧠 10-day rule is critical for MSRA exams

📌 Common Bacterial Pathogens
• Streptococcus pneumoniae
• Haemophilus influenzae
• Moraxella catarrhalis

📌 Risk Factors
• Viral URTI, allergic rhinitis
• Nasal polyps, deviated septum
• Immunodeficiency, cystic fibrosis
• Recent dental work
• Environmental exposure (pollution, smoke)

📌 Pathophysiology
Viral infection → mucosal swelling → blocked sinus drainage → mucus stasis → bacterial overgrowth

📌 Symptoms
• Facial pain/pressure
• Purulent nasal discharge
• Nasal obstruction
• Hyposmia
• Headache, fever, fatigue
• Halitosis

📌 Diagnosis
• Clinical diagnosis based on symptom duration and severity
• Imaging (CT) or labs only if complications or poor response to treatment
• Avoid routine bloods or swabs unless red flags

📌 Management
🧴 Initial (non-antibiotic) management:
• Analgesia, saline irrigation, intranasal steroids
• Intranasal decongestants (short-term only)
• Reassurance and observation <10 days

💊 Antibiotics ONLY if:
• Symptoms persist >10 days
• Worsening after initial improvement
• Systemically unwell or immunocompromised

🧠 First-line:
• Phenoxymethylpenicillin OR doxycycline
• If severe or high-risk: Co-amoxiclav
• Penicillin allergy: Doxycycline
• Pregnancy: Erythromycin
• Avoid doxycycline in children

📌 Complications (Rare but serious)
• Orbital cellulitis, periorbital cellulitis
• Meningitis, brain abscess
• Cavernous sinus thrombosis
• Osteomyelitis of the frontal bone
• Chronic sinusitis
• Cutaneous fistula formation

📚 MSRA Resources for Acute Bacterial Sinusitis
📝 Revision Notes:
https://www.passthemsra.com/topic/acute-bacterial-sinusitis-revision-notes/
🧠 Flashcards:
https://www.passthemsra.com/topic/acute-bacterial-sinusitis-flashcards/
💬 Accordion Q&A Notes:
https://www.passthemsra.com/topic/acute-bacterial-sinusitis-accordion-qa-notes/
🚀 Rapid Quiz:
https://www.passthemsra.com/topic/acute-bacterial-sinusitis-rapid-quiz/
🎓 ENT Course:
https://www.passthemsra.com/courses/ent-for-the-msra/
🧪 Quiz Bank:
https://www.passthemsra.com/quizzes/acute-bacterial-sinusitis/

🔖 Hashtags
#MSRA #MSRARevision #MSRATextbook #MSRAQuiz #MSRAFlashcards #MSRAQANotes #MSRAAccordions #MultiSpecialtyRecruitmentAssessment #ENT #AcuteBacterialSinusitis #Rhinosinusitis

🎙️ Podcast Deep Dive: Acute Laryngitis Explained
Struggling with hoarseness, voice loss or a dry scratchy throat? 🎤 In this high-yield episode, we unravel the essentials of Acute and Chronic Laryngitis – from red flag symptoms 🚨 to practical management tips and differential diagnoses every MSRA candidate should know!

🧠 Key Learning Points

📌 Definition
Laryngitis = Inflammation of the larynx (voice box), most commonly viral and self-limiting.

📌 Types

• Acute: Lasts <7 days

• Chronic: >3 weeks – with different causes like reflux, voice misuse, smoking & more!

📌 Causes

• Acute: Viruses (rhinovirus, RSV, influenza) 🦠

• Chronic: Smoking 🚬, reflux (LPR) 🔥, allergies 🌿, voice strain, ACE inhibitors 💊

📌 Pathophysiology
Inflamed vocal cords swell, disrupting vibration → hoarseness, voice fatigue & loss of pitch 🎶

📌 Symptoms
Hoarseness, sore throat, dry cough, voice changes

• Cold symptoms 🤧, globus sensation, fatigue

📌 Red Flags
⚠️ Persistent hoarseness >3 weeks
⚠️ Stridor (inspiratory wheeze)
⚠️ Difficulty breathing/swallowing
⚠️ Lump in neck
⚠️ Weight loss
⚠️ Age >45 + smoker = urgent 2WW referral 🚨

📌 Differentials

• Vocal cord nodules/polyps

• GERD/LPR

• Tumours

• Vocal cord paralysis

• Iatrogenic injury

• Med-induced causes (e.g. antipsychotics, steroids)

📌 Investigations
🩺 Acute: Clinical dx, no tests needed
🧪 Chronic: FBC, laryngoscopy, pH monitoring, imaging (CT/MRI), stroboscopy

📌 Management
💧 Voice rest
☁️ Steam inhalation
💊 Paracetamol/NSAIDs
❌ No antibiotics (unless bacterial suspected)
🗣️ Chronic: Speech therapy, treat cause (e.g. PPIs for reflux), surgery if needed

📌 Prognosis
👍 Acute = excellent – resolves in 7–10 days
⚠️ Chronic requires proper workup to avoid complications

📌 Complications

• Vocal cord damage

• Supraglottitis

• Chronic cough

• Airway obstruction (rare)

🛠️ Useful MSRA Resources on Acute Laryngitis
📝 Revision Notes:
https://www.passthemsra.com/topic/acute-laryngitis-revision-notes/

🧠 Flashcards:
https://www.passthemsra.com/topic/acute-laryngitis-flashcards/

❓ Q&A Accordion Notes:
https://www.passthemsra.com/topic/acute-laryngitis-accordion-qa-notes/

🔥 Rapid Quiz:
https://www.passthemsra.com/topic/acute-laryngitis-rapid-quiz/

🧪 Quiz Portal:
https://www.passthemsra.com/quizzes/acute-laryngitis/

📚 Full ENT Course for MSRA:
https://www.passthemsra.com/courses/ent-for-the-msra/

🌐 Full Free MSRA Resource Hub:
https://www.freemsera.com

🎧 Whether you're prepping for the MSRA or refreshing clinical knowledge, this is your shortcut to mastering one of the most common ENT conditions. Perfect for GP trainees, IMT applicants, or anyone revising smart.

#MSRA #Laryngitis #ENTforMSRA #AcuteLaryngitis #MSRARevision #PassTheMSRA #FreeMSRA #VoiceLoss #ENTpathology #2WW #Hoarseness #ClinicalRedFlags